CAN refers to the progressive decline of renal function seen in some renal transplant recipients in association with alloantigen-dependent and alloantigen-independent factors. Hyperlipidemia is a known risk factor for cardiovascular disease and CAN in adult renal transplant recipients, whereas no data exist in the pediatric transplant population. In this cross-sectional study, 62 renal transplant recipients (32 CAN vs. 30 non-CAN) aged 5-18 yr and with the mean follow-up time of 48 months (9-93) after transplantation were evaluated for lipid profile and renal function tests. Hyperlipidemia has high prevalence in our patients both pre- and post-transplantation. Furthermore, hypercholesterolemia and high-LDL cholesterol levels have significant association with CAN (p = 0.019 and p = 0.039, respectively). In pediatric recipients, hyperlipidemia and particularly hypercholesterolemia have significant association with CAN and adults may need specific therapy.